Frey C: Foot health and shoewear for women. .Clin Orthop Relat Res 372::32. ,2000. .
Kastenbauer T, Sokol G, Auinger M, et al: Running shoes for relief of plantar pressure in diabetic patients. .Diabet Med 15::518. ,1998. .
Koepsell TD, Wolf ME, Buchner DM, et al: Footwear style and risk of falls in older adults. .J Am Geriatr Soc 53::1495. ,2004. .
Perry JE, Ulbrecht JS, Derr JA, et al: The use of running shoes to reduce plantar pressures in patients who have diabetes. .J Bone Joint Surg Am 77::1819. ,1995. .
Sherrington C, Menz HB: An evaluation of footwear worn at the time of fall-related hip fracture. .Age Ageing 32::310. ,2003. .
Birke JA, Foto JG, Pfiefer LA: Effect of orthosis material hardness on walking pressure in high-risk diabetes patients. .J Prosthet Orthot 11::43. ,1999. .
Boulton AJM, Betts RP, Franks CI, et al: Abnormalities of foot pressure in early diabetic neuropathy. .Diabet Med 4::225. ,1987. .
Fernando DJS, Masson EA, Veves A, et al: Relationship of limited joint mobility to abnormal foot pressures and diabetic foot ulceration. .Diabetes Care 14::8. ,1991. .
Young MJ, Cavanagh PR, Thomas G, et al: The effect of callus removal on dynamic plantar foot pressures in diabetic patients. .Diabet Med 9::55. ,1991. .
About orthopaedic surgery: foot. Northern Rockies Orthopaedics Web site. http://www.orthopaedic.com/pefoot.htm. Accessed August 5. ,2008. .
Foot corns & callus (hyperkeratosis). ePodiatry.com Web site. http://www.epodiatry.com/corns-callus.htm. Accessed August 5. ,2008. .
Metatarsalgia. Toe to Toe Dance Shoes Web site. http://www.toe2toe.com/accessories/footcare/orthotics/reasons.htm#metatarsalgia. Accessed August 5. ,2008. .
Armstrong DG, Lavery LA: Elevated peak plantar pressures in patients who have Charcot arthropathy. .J Bone Joint Surg Am 80::365. ,1998. .
Cavanagh PR, Ulbrecht JS, Caputo GM: New developments in the biomechanics of the diabetic foot. .Diabetes Metab Res Rev 16: (suppl 1):S6. ,2000. .
Lobmann R, Kayser R, Kasten G, et al: Effects of preventative footwear on foot pressure as determined by pedobarography in diabetic patients: a prospective study. .Diabet Med 18::314. ,2001. .
Smith L, Plehwe W, McGill M, et al: Foot bearing pressure in patients with unilateral diabetic foot ulcers. .Diabet Med 6::573. ,1989. .
Stokes IAF, Faris IB, Hutton WC: The neuropathic ulcer and loads on the foot in diabetic patients. .Acta Orthop Scand 46::839. ,1975. .
Veves A, Murray HJ, Young MJ, et al: The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study. .Diabetologia 35::660. ,1992. .
Ahroni JH, Boyko EJ, Forsberg R: Reliability of F-scan in-shoe measurements of plantar pressure. .Foot Ankle Int 19::668. ,1998. .
Background: High peak plantar pressures predispose to foot problems and may exacerbate existing conditions. For podiatric physicians to make educated recommendations to their patients, it is important and necessary to begin to look at different shoes and how they affect peak plantar pressure.
Methods: To determine how flip-flops change peak plantar pressure while walking, we compared peak plantar pressures in the same test subjects wearing flip-flops, wearing athletic shoes, and in bare feet. Ten women with size 7 feet and a body mass index less than 25 kg/m2 were tested with an in-shoe pressure-measurement system. These data were collected and analyzed by one-way analysis of variance and computer software.
Results: Statistically significant results were obtained for nine of the 18 comparisons. In each of these comparisons, flip-flops always demonstrated higher peak plantar pressures than athletic shoes but lower pressures than bare feet.
Conclusion: Although these data demonstrate that flip-flops have a minor protective role as a shock absorber during the gait cycle compared with pressures measured while barefoot, compared with athletic shoes, they increase peak plantar pressures, placing the foot at greater risk for pathologic abnormalities. (J Am Podiatr Med Assoc 98(5): 374–378, 2008)